cannulation. In older children and adolescents, US guided catheter
insertion is acceptable.
Pre-insertion preparation should include evaluation of hematologic
parameters; platelet count of at least 50,000 and INR of no greater than
1.5 times normal.
In children with previous multiple access catheters, US study to evaluate
the patency of the veins to be used should be done.
Cutdown technique involves the use of general anesthesia in children.
Tunneled dialysis catheters can be used in children who will require
prolonged HD and in those waiting for renal transplantation.Complications of RRT
- Hypotension
- Bleeding
- Electrolyte an acid/base imbalance
Metabolic alkalosis is seen in circuits using citrate as an anticoagulant,
citrate is metabolized to bicarbonate in the liver. - Air embolism
- Catheter malfunction
- Catheter infection
Signs of infection should prompt blood cultures and the initiation of empiric
antibiotics.